• Title/Summary/Keyword: sentinel lymph node

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Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck

  • Ryu, Wan Cheol;Koh, In Chang;Lee, Yong Hae;Cha, Jong Hyun;Kim, Sang Il;Kim, Chang Gyun
    • Archives of Craniofacial Surgery
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    • v.18 no.1
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    • pp.37-43
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    • 2017
  • Background: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. Methods: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. Results: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. Conclusion: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

Two separate nodules of Merkel cell carcinoma occurring concomitantly on one cheek

  • Hwang, Woosuk;Kang, Mi Seon;Kim, Jin Woo
    • Archives of Craniofacial Surgery
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    • v.20 no.3
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    • pp.203-206
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    • 2019
  • Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.

Detection of Superior Markers for Polymerase Chain Reaction Diagnosis of Breast Cancer Micrometastasis in Sentinel Lymph Nodes

  • Shargh, Shohreh Alizadeh;Movafagh, Abolfazl;Zarghami, Nosratolah;Sayad, Arezou;Mansouri, Neda;Taheri, Mohammad;Pour, Atefeh Heidary;Iranpour, Mostafa;Ghaedi, Hamid;Montazeri, Vahid;Massoudi, Nilofar;Hashemi, Mehrdad;Mortazavi-Tabatabaei, SA
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.179-183
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    • 2016
  • Breast cancer is the most prevalent type of cancer among women around the world, and mortality is primarily caused by micro-metastatic disease. The complex mechanisms of breast cancer invasion and metastasis are intrinsically related to the malignant cell type so that early detection of micro-metastases can help prolongation of survival for patient. The aim of the present research work was evaluation of the expression status of mammoglobin protein as a candidate molecular marker in the negative sentinel lymph node (SLN). Fifty tumor specimens, and 50 normal adjacent breast tissue samples from the same patients were selected on the basis of having more than 10% tumor content for RNA extraction from SLNs. Tumor samples and normal adjacent breast tissue were archived in the form of frozen fresh tissue in liquid nitrogen. Real-time PCR was performed on a Bioner life express gradient thermal cycler system. Mammoglobin gene overexpression in breast cancer metastasis was investigated. Single marker results were mammaglobin 66.7% and CK19 50.0%, with 58.3% for the two in combination. Due to improved outcome with at least 3 genes (83.3%), it seems, triple marker evaluation will be most likely useful for detecting micro-metastases instead of studying separate genes.

A case of Merkel cell carcinoma of the head and neck

  • Suk, Sangwoo;Shin, Hyun Woo;Yoon, Kun Chul
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.401-404
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    • 2019
  • Merkel cell carcinoma (MCC) is a relatively rare and aggressive cutaneous neuroendocrine malignancy. It is characterized by high rates of recurrence and metastasis, both to regional lymph nodes and to distant locations. Its characteristic clinical manifestation is a single, painless, hard, erythematous nodule on a sun-exposed area, particularly in older men. Surgical management of both the primary site and the sentinel lymph node is the standard of care. In this article, we describe the diagnosis and treatment of a case of MCC in the left cheek.

Patients' Experiences of Sensations After Breast Cancer Surgery in Korean Women (유방암 수술 환자의 감각 변화에 대한 연구)

  • Jeong, Young-Hee;Kim, Dal-Sook
    • Asian Oncology Nursing
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    • v.9 no.2
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    • pp.145-154
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    • 2009
  • Purpose: The purpose of this study was to obtain information about the experiences of sensations after breast cancer surgery characterized by prevalence, frequency, and severity, distresses, and disturbances in ADL using the BSAS (Breast Sensation Assessment Scale) and to develop the standardized Korean BSAS. Methods: Thirty two women from 3 to 100 days after breast cancer surgery (BCS) completed Roberta's BSAS. The 18 sensations of BSAS were translated using the references of Lee's Korean Pain Rating Scale and English-English, English-Korean dictionaries and the consultation from two native Americans, one bilingual permanent resident of the States, and one nursing professor. The Korean-translated BSAS has high reliability in test-retest. Likert type 4-point scale and 100 mm VAS were used for assessment. Results: Certain sensations remained prevalent (tender, pull, pain), frequent (numb, nag, throb), severe (throb, shoot, numb), causing distress (throb, penetrate, shoot), and influencing on ADL (throb, penetrate, nag). The most frequently experienced sensation other than BSAS was itching. There was little difference in the prevalence of symptom experiences between sentinel lymph node biopsy and axillary lymph node dissection. Conclusion: The women after BCS are suffering from neuropathic sensations. The Korean- translated BSAS could be used in effectively assessing breast sensations after BCS in Korean women.

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Clinically translatable photoacoustic imaging of cancer diagnosis (임상적용이 가능한 광음향 암 진단 기술)

  • Kim, Mi-Ji;Park, Yeon-Seong;Yoon, Changhan
    • The Journal of the Acoustical Society of Korea
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    • v.38 no.4
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    • pp.476-484
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    • 2019
  • Photoacoustic imaging is a hybrid real-time imaging technique that combines high optical contrast and ultrasonic resolution. It has primarily been utilized in pre-clinical research and has evolved into clinical practice. In this paper, we review photoacosutic imaging for detection of primary canccer and metastatis and its limitation in translation from pre-clinical to clinical application.

A Clinical Case of Axillary Web Syndrome after Glandular Tissue and Skin Removal for Axillary Osmidrosis (한선 및 피부절제술을 이용한 액취증 수술 후 발생한 Axillary Web Syndrome의 치험례)

  • Choi, Min-Seok;Kim, Woo-Seob;Kim, Han-Koo;Bae, Tae-Hui
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.301-303
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    • 2010
  • Purpose: The axillary web syndrome (AWS) is a selflimiting cause of morbidity in the early postoperative period after axillary surgery. This article presents a rare complication developed after surgical treatment for axillary osmidrosis. Methods: A 55-year-old male patient underwent surgical excision of skin and glandular tissue for axillary osmidrosis. Three weeks after the surgery, he visited our department due to a visible web of left axillary skin overlying palpable cord extends into the medial ipsilateral arm. There was a taut and tender cord of tissue under the skin and shoulder abduction was limited to less than 90 degrees. He was diagnosed with AWS and treated with conservative management. Results: Four months later, AWS resolved completely without any treatment and patient was free of pain or motion restriction. Conculsion: Axillary web syndrome has been described as frequent complication after axillary lymph node dissection or sentinel node biopsy, but not after surgical treatment of axillary osmidrosis. Surgeons must be aware of the risk of axillary web syndrome after treatment of axillary osmidrosis.

Recent advances of basal cell carcinoma, squamous cell carcinoma, and carcinoma in situ (기저세포암, 편평세포암 및 피부내암의 최신지견)

  • Park, Kun
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.655-661
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    • 2018
  • Incidence of basal and squamous cell carcinoma is increasing among Korean. With increasing this incidence we need to attend the management and prevention of these cutaneous malignancies. Basal cell carcinoma (BCC) is the most common skin malignancy. Sun exposure is the most important environmental cause of BCC. Daily sun protection especially avoiding sun exposure between 10 a.m. and 4 p.m. provides most effective prevention against chronic ultraviolet-induced skin damage. Hedgehog pathway inhibitors are used locally advanced and metastatic BCC lesions in Korea. Until recently, there are no reports whether it developed resistance of Hedgehog pathway inhibitors with advanced BCC in Korean patients. Among malignant skin tumors, 19.1% were squamous cell carcinoma (SCC). The incidence of SCC was rapidly increased over the past years. However, the incidence rate of SCC in Japan has not been changed from the period 1976-1980 to 1986-1990. Sentinel lymph node biopsy for SCC did not provide diagnostic value. Bowen's disease and Erythroplasia of Queyrat are considered as carcinoma in situ of the skin. Erythroplasia of Queyrat have worse prognosis with a higher rate of malignant degeneration. Dermoscopy may helpful tool in assisting the noninvasive diagnosis of carcinoma in situ of the skin.